Comparison of Survival Rates After a Combination of Local Treatment and Systemic Therapy vs Systemic Therapy Alone for Treatment of Stage IV Non–Small Cell Lung Cancer

Key Points Question Is there a survival benefit to combining local treatment and systemic therapy for stage IV non–small cell lung cancer? Findings In this comparative effectiveness research study, overall survival of patients with stage IV non–small cell lung cancer was superior for combination of systemic therapy with surgical resection or external beam radiotherapy/thermal ablation of the primary tumor site compared with systemic therapy alone. Effectiveness of external beam radiotherapy/thermal ablation varied with histologic and other tumor characteristics. Meaning In stage IV non–small cell lung cancer, surgical resection or external beam radiotherapy/thermal ablation of the primary tumor site may provide survival benefits in addition to systemic therapy alone for selected patients.